I understand it to mean Paid Time Off, but I object to the frame of reference it creates.
I feel it is designed to plant a seed of guilt if you apply for it or (even worse) actually use it. “Oh you want PTO? You expect to be paid while you go to the doctor or look after your kids or even take a holiday?” It creates the mindset that they are doing you a favour; they are paying you while you should be working.
Other jurisdictions call it Annual Leave or Annual Holidays and this to me is right. If you're in a place you accrue 'time off' at a certain rate, that's your holiday time whether you go to Nepal, binge Netflix or look after a sick relative.
It's a subtle semantic shift I've noticed and it makes me goddam furious. This sub is full of people who want to take time off and supposedly have access to it but are made to feel uncomfortable or guilty to even consider it.
/rant